Title

Author

Date

May 2009

Document Type

Capstone

Degree Name

M.B.I.

Department

Dept. of Medical Informatics and Clinical Epidemiology

Institution

Oregon Health & Science University

Abstract

This pilot research project examined the many purposes and activities of medical rounds. Crucial for teaching and patient care in an academic medical center, rounds were categorized against the framework of distributed cognition, a theory of cognition grounded in cognitive anthropology. Through a series of observations of interdisciplinary rounds in academic medical intensive care settings, supplemented by interviews with participants, the multiple purposes and perspectives of rounds were organized into a categorical list to aid future work on the topic, especially as they apply to technology development and the field of medical informatics. The theory of distributed cognition focuses on the idea of an activity system composed of a common body of knowledge that organizes the interactions of many actors and their tools around a common purpose. Applied first in educational and social settings, the theory is being applied to the healthcare arena. This work explores the application of such diffuse knowledge in an intensive care setting. The results of this pilot observation and interview study is a tentative taxonomy of types of medical rounds, as well as their characteristics and key facilitators. By first creating a clear conception of the types of rounds themselves, the path is cleared for future work on how distributed cognition can improve understanding of cognitive performance in the intensive care setting. This can allow the biomedical informatics community to incorporate aspects of this model into future information tool design, as well as improved teaching and patient safety. Careful attention should be given to the diverse needs represented in different types of rounds, and a modular approach employed to address them.

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